Optimizing Hiv Testing Algorithms
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Optimizing HIV testing algorithms
A standardized HIV testing strategy and quality-assured products are critical for accurate diagnosis, while poorly chosen testing algorithms can lead to misdiagnosis. Verification of testing algorithms provides objective evidence, before widespread implementation, that a specific combination of products will accurately diagnose HIV infection, thus reducing the risk of misdiagnosis. The toolkit aims to provide countries with the tools and content needed to effectively conduct a local verification assessment to update national HIV testing algorithms following WHO recommendations on HIV testing strategies. The toolkit consists of (1) a generic assessment protocol that can be adapted and submitted for local ethical clearance; (2) a test selection tool to assist with the selection of WHO prequalified HIV assays based on performance and operational characteristics; (3) a Gantt chart to plan and schedule the different project implementation activities; (4) a general budget required to conduct this assessment; (5) a checklist of test kits, consumables and supplies needed for placing a purchase order and; (6) a database to assist with data analysis.
Preventing HIV misdiagnosis
Author: World Health Organization
language: en
Publisher: World Health Organization
Release Date: 2024-11-07
HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes and public health. With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment. This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
WHO operational handbook on tuberculosis. Module 6
Author: World Health Organization
language: en
Publisher: World Health Organization
Release Date: 2025-01-09
Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.